Nakamura Satoshi, Hashimoto Yoshio, Nishi Kaoru, Mizumoto Tosihiro, Takahashi Hidetoshi, Iizuka Hajime
Department of Dermatology, Asahikawa Kousei Hospital, Asahikawa, Japan;
Department of Dermatology, Asahikawa Medical University, Asahikawa, Japan.
J Dermatol Case Rep. 2014 Mar 31;8(1):16-9. doi: 10.3315/jdcr.2014.1164.
Cutaneous adverse events associated with the use of epidermal growth factor receptor inhibitors, such as cetuximab are relatively common. Although there are reports about possible treatments for acne or acneiform lesions induced by cetuximab, there are only few reports of prospective studies.
The aim of the study was to analyze the efficacy of varius treatment modalities and their combinations in patients with acneiform eruptions caused by cetuximab.
We studied 14 patients treated with an epidermal growth factor receptor inhibitors, including 7 patients cetuximab, who developed acneiform eruptions in the course of therapy. All patients were diagnosed as grade II according to the Common Terminology Criteria for Adverse Events (CTCAE) v4.0. A corticosteroid ointment, tacrolimus ointment, and ketoconazole ointment were used in a randomized manner. Oral therapy included administration of antihistaminic drugs, tetracycline, a cyclooxygenase inhibitor, or a macrolide. We measured the numer of days required to achieve improvement from grade II to grade I during cetuximab treatment.
Our results showed that tetracycline treatment may shorten the period needed to achieve improvement. Ketoconazole cream and a combination of oral tetracycline and topical ketoconazole also significantly shortened this period.
The results of our short case study may indicate that a combitation therapy of oral tetracyclin and topical ketokonazole is most effective in the therapy of patients with acneiform eruptions caused by cetuximab.
与使用表皮生长因子受体抑制剂（如西妥昔单抗）相关的皮肤不良事件相对常见。尽管有关于西妥昔单抗所致痤疮或痤疮样皮疹可能治疗方法的报道，但前瞻性研究的报道却很少。
本研究旨在分析多种治疗方式及其联合应用对西妥昔单抗所致痤疮样皮疹患者的疗效。
我们研究了14例接受表皮生长因子受体抑制剂治疗的患者，其中7例使用西妥昔单抗的患者在治疗过程中出现了痤疮样皮疹。根据不良事件通用术语标准（CTCAE）v4.0，所有患者均被诊断为Ⅱ级。随机使用皮质类固醇软膏、他克莫司软膏和酮康唑软膏。口服治疗包括给予抗组胺药、四环素、环氧化酶抑制剂或大环内酯类药物。我们测量了在西妥昔单抗治疗期间从Ⅱ级改善到Ⅰ级所需的天数。
我们的结果表明，四环素治疗可能缩短改善所需的时间。酮康唑乳膏以及口服四环素与外用酮康唑联合使用也显著缩短了这一时期。
我们这项简短病例研究的结果可能表明，口服四环素与外用酮康唑联合治疗对西妥昔单抗所致痤疮样皮疹患者最为有效。
